Abstract
This report describes the epidemiological features of the first outbreak caused by KPC3 carbapenemase-producing Klebsiella pneumoniae (KPC-3-KP) in Spain and how it was effectively controlled. From 16 September 2009 to the end of February 2010, seven patients infected or colonised with KPC-3-KP were detected. Stool surveillance cultures were recovered from patients, doctors, nurses, nursing assistants, cleaners and hospital porters working in the affected units. Hand swabs were taken from workers and patients’ relatives for culturing. Environmental samples were also taken. Patients infected or colonised with KPC-3-KP were placed in single rooms under contact precautions and 4% chlorhexidine soap was used for their daily hygiene. Staff attended educational seminars and workshops on hand hygiene and isolation of patients. An alcohol-based disinfectant was used for surface cleaning and disinfecting. The floor was cleaned with a disinfectant containing benzalkonium chloride and didecyldimethylammonium. All samples collected were negative for KPC-3-KP. After implementing the control measures, no further cases were reported in the affected units. All cases had comorbidities, long hospital stay and aggressive/intensive antimicrobial treatment. This study emphasises the importance of early intensification of infection control to interrupt the transmission of KPC-producing organisms.
Highlights
Carbapenems are widely regarded as the drugs of choice for the treatment of severe infections caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae [1]
We report here the epidemiological features of the first outbreak by KPC3 carbapenemase-producing K. pneumoniae (KPC-3-KP) in Spain and how it was controlled
Ten days after admission KPC-3-KP was isolated in a rectal culture during a routine investigation of rectal carriage of ESBL-producing isolates
Summary
Carbapenems are widely regarded as the drugs of choice for the treatment of severe infections caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae [1]. Carbapenemases are a large and diverse family of microbial enzymes that hydrolyse carbapenems and other beta-lactam antibiotics. KPC-producing Klebsiella pneumoniae were first isolated in North Carolina in 1996 [4] and until 2004 these enzymes were found only in the United States [5,6,7]. The first outbreak of KPC-producing K. pneumoniae outside the United States was described in Tel Aviv in 2006 [8]. The strains isolated in Israel were genetically identical to the ones previously isolated in the United States. This supported the hypothesis that the KPC producer was transferred from the United States to Israel [9]. And France have recently described a rapid increase in the number of of cases [16,17]
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